NPIMap

Individual provider Active NPI

Andrew Manos, PA-C

  • Physician Assistant
  • Golden Valley, MN
National Provider Identifier
1295126639
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12043 Issued in MN
Practice address
8401 Golden Valley Rd Ste 340
Golden Valley, MN 55427-4488
Phone
(952) 960-9399
Fax
(952) 206-6467
NPI assigned
Feb 6, 2015
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12043 MN Primary

Addresses

Primary practice location

8401 Golden Valley Rd Ste 340
Golden Valley, MN 55427-4488

Mailing address

8401 Golden Valley Rd Ste 340
Golden Valley, MN 55427-4488
Phone (952) 960-9399

Other practice location 1

909 Fulton St SE
University of MN Health Ambulatory Surgery Center
Minneapolis, MN 55455-4800
Phone (612) 676-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160401000352 MN Practitioner - Physician Assistant 9133426349 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endovascular Physicians of Minnesota PLLCGroup PAC ID 5991168254, 5 clinicians

Practice addresses (Care Compare)

8401 Golden Valley Rd
Golden Valley, MN 55427-4488
Phone (952) 960-9399

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12043MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Dec 3, 2016 Accepting new patients
Fairview Health Services CurrentSince Feb 21, 2016 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Group Health, Inc. CurrentSince Dec 3, 2016 Accepting new patients
Fairview Health Services CurrentSince Feb 21, 2016 Accepting new patients

Locations

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: andrew.manos.1@30987.direct.athenahealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1295126639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 GOLDEN VALLEY RD STE 340",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274488",
            "telephone_number": "952-960-9399",
            "fax_number": "952-206-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 GOLDEN VALLEY RD STE 340",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274488",
            "telephone_number": "952-960-9399",
            "fax_number": "952-206-6467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Fulton St SE",
            "address_2": "University of MN Health Ambulatory Surgery Center",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554554800",
            "country_code": "US",
            "telephone_number": "612-676-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANOS",
        "first_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-06",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.